Assessment of dentinal hypersensitivity in fluorosed and non fluorosed subjects–a clinical study

Abstract

Background & objectives: Dentin Hypersensitivity(DH) is an exaggerated response to a sensory stimulus that usually causes no response in a normal, healthy tooth which hinders the ability to control dental plaque and compromises oral health. Dental fluorosis is an unfortunate side-effect of fluoride's caries-protective benefits, which brings about mineralisation changes in a dentinal structure leading to dentin hypersensitivity. Methodology: 404 healthy subjects with and without fluorosis were examined for Dentinal hypersensitivity using tactile and air sensitivity methods. The subjects rated the pain associated with Dentinal hypersensitivity on categorical Verbal rating scale (VRS). Clinical parameters including Turesky modification of Quigley-Hein plaque index (TMQH), gingival recession, labioversion and wasting diseases (attrition, abrasion, erosion,abfraction) were recorded. The tooth brushing habits used by the subjects were also considered. Results: Results showed that fluorosed subjects were suffering from DH significantly greater than non-fluorosed subjects, giving a prevalence of 22.7% and 11.1% in fluorosed and nonfluorosed subjects, respectively. (p<0.001) The severity of DH increased proportionally with increase in severity of fluorosis. Significantly increased plaque scores were observed in fluorosed teeth. (p<0.05) Gingival recession, labioversion as well as wasting diseases were significantly associated with DH. (p<0.05) Females had significant esthetic concern, psychological impact of dental fluorosis and had a better attitude and desire to seek dental treatment compared to males. Overall, there was limited knowledge about the etiology and prevention of dental fluorosis in the study subjects. Interpretation and conclusion: There is a greater prevalence of dentinal hypersensitivity in subjects with dental fluorosis which could be due to fluoride induced enamel and dentinal structural changes leading to rough surface morphology and greater plaque accumulation. There is a need to educate the population regarding the dental effects of fluoride and its management.